Applied Behavior Analysis (ABA) therapy for children with autism has been proven to work over a period of time. However, as a parent you may not have the necessary experience or background to determine if the level of expertise of a practitioner is meeting your child’s goals and needs.
Beyond the obvious signs of whether or not your child is making progress, there are some other factors when assessing a provider that you can use to evaluate their potential effectiveness. Here’s a tool-kit that you can use.
– How many children are on your BCBA/ BCaBA’s caseload? Of course, you might also want to check if the individual overseeing your child’s program is credentialed (Board Certified). The best way to find out is to ask directly. If that doesn’t work then you can approximate this by comparing the total number of children in the program with the total number of BCBAs/ BCaBAs. There is no ‘correct’ number of children per BCBA/ BCaBA (it depends on the complexity of each program, the experience of the staff, number of assistants etc). In our experience a good approximation is no more than 10. You can also think about it this way – if your BCBA/ BCaBA has, for example, 15 kids, then assuming they spend about 2 hours a week with each child, that adds up to 30 hours (assuming no travel time from one location to another). Now each child’s care also involves programming time (writing reports, collecting data training with staff etc). Conservatively allocating around 1 hour per child for programming time totals 15 additional hours for a total of 45 hours. Add in usual administrative time for meetings, emails and other non-clinical weekly activities and very soon you’re above 50 hours/ week. This is not an effective setting for providing quality of care and leads to compromises and shortcuts.
– How many individuals are assigned to your child’s team? An effective model involves more than just the BCBA/ BCaBA overseeing a child’s program – such as such as trainers, program managers (or people assisting BCBA/ BCaBAs etc). Additional team members should be assisting with some of the tasks mentioned above.
– Is your child’s team trained? How effective a provider’s training program is can have a direct correlation with how good your child’s program will be. You should inquire about your provider’s training program and methodology to ensure adequate attention is devoted to this.
– Is parent training offered? For a child’s program to be successful – you should be able to ask for and receive training to implement some of the principles at home that are being used with your child everyday.
– Is the child actually receiving one on one therapy? – Or are multiple children overseen by a therapist? For ABA services to be most beneficial – your child should be one on one with a therapist. Your child’s therapist should not be paired with multiple kids at once. This is important not only for the quality of care – but also for how billing is done (if services are being accessed through health insurance)
– Are you allowed free and open access to your child’s team and to his/ her sessions? If not, that is a red flag… it is your child, after all and you should be able to observe your child’s sessions. (Incidentally this is also a good way to check the above points about one on one therapy).
– Are you able to interact with your child’s team on a regular basis and develop a good working relationship? The level of communication and involvement that you have with your child’s team is a good measure of how vested the provider is in your child’s program.
– What is the general vibe and environment like at the place of service? Schedule a visit or request and observation. You can tell a lot by observing and interacting with the team.
– Does your child’s staff take proper data and clinical note? You should be able to get a summary of your child’s sessions – either upon request or as a regular part of the process. This is a good way for you to stay up to speed with your child’s progress.
Since time is your most valuable resource, especially when your child’s progress is concerned – it is crucial to have a toolkit to assess the effectiveness of your provider. These questions should serve as a starting point for you.
Further reading: http://www.bacb.com/Downloadfiles/ABA_Guidelines_for_ASD.pdf